Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED)
0.1.0 - ci-build
Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED)
0.1.0 - ci-build
Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
{
"resourceType" : "Claim",
"id" : "LKFRequest42",
"meta" : {
"profile" : [
🔗 "https://elga.moped.at/StructureDefinition/MopedLKFRequest"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim LKFRequest42</b></p><a name=\"LKFRequest42\"> </a><a name=\"hcLKFRequest42\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-MopedLKFRequest.html\">MOPED LKFRequest</a></p></div><p><b>Abrechnung - Knoten</b>: <a href=\"CodeSystem-LKFAbrechnungsKnotenCS.html#LKFAbrechnungsKnotenCS-D\">LKF Abrechnungsknoten D</a>: D</p><p><b>Fondsrelevanz</b>: <a href=\"CodeSystem-FondsrelevanzCS.html#FondsrelevanzCS-J\">Fondsrelevanz J</a>: Ja (Abrechnung des stationären Aufenthalts/ambulanten Besuchs erfolgt über den Landesgesundheitsfonds/PRIKRAF)</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-Patient42.html\">Patient42 Patient42FamilienName Male, DoB: 1937-12-31 ( Social Security Number: 123456)</a></p><p><b>created</b>: 2025-08-30</p><p><b>insurer</b>: <a href=\"Organization-SV11.html\">Organization Österreichische Gesundheitskasse Wien</a></p><p><b>provider</b>: <a href=\"Organization-KHK999.html\">Organization Testkrankenhaus</a></p><p><b>encounter</b>: </p><ul><li><a href=\"Encounter-Encounter42.html\">Encounter: extension = ; identifier = Visit number,Anonymous identifier; status = completed; class = Stationär,geplante stationäre Aufnahme/geplanter ambulanter Besuch (mit vorhergehender Terminvereinbarung, Richtwert: mindestens 24 Stunden); type = Moped Encounter; actualPeriod = 2025-01-01 12:00:00+0200 --> 2025-01-04 12:00:00+0200</a></li><li><a href=\"Encounter-TransferEncounter42.1.html\">Encounter: status = completed; type = Moped Transfer Encounter; actualPeriod = 2025-01-01 --> (ongoing)</a></li><li><a href=\"Encounter-TransferEncounter42.2.html\">Encounter: status = completed; type = Moped Transfer Encounter; actualPeriod = 2025-01-02 00:00:00+0200 --> 2025-01-04 00:00:00+0200</a></li></ul><p><b>diagnosisRelatedGroup</b>: <span title=\"Codes:{https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS HDG01.12}\">HDG01.12</span></p><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS PLAUS}\">Plausibilitätskennzeichen</span></p><p><b>value</b>: 2</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS ENDG}\">Endgültige Meldung</span></p><p><b>value</b>: true</p></blockquote><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>OnAdmission</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Condition-Condition42.1.html\">Condition G40.0</a></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosis-on-admission unknown}\">Unknown</span></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS LDFPLK}\">Leistungskomponente/Leistungspunkte</span></p><p><b>quantity</b>: 366.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS LDFPTK}\">Tageskomponente/Kontaktpunktet</span></p><p><b>quantity</b>: 2730.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCULK}\">Punkte Belagsdauerausreißer nach unten – Leistungskomponente</span></p><p><b>quantity</b>: 0.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCUTK}\">Punkte Belagsdauerausreißer nach unten – Tageskomponente</span></p><p><b>quantity</b>: 0.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 5</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS BDZU}\">Zusatzpunkte Belagsdauerausreißer nach oben</span></p><p><b>quantity</b>: 0.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 6</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS INTZU}\">Zusatzpunkte Intensiv</span></p><p><b>quantity</b>: 2436.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 7</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS MELZU}\">Zusatzpunkte Mehrfachleistungen</span></p><p><b>quantity</b>: 0.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 8</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCSPEZ}\">Punkte spezieller Bereiche (tageweise)</span></p><p><b>quantity</b>: 0.0 LKF Punkte</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 9</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCGES}\">Punkte total</span></p><p><b>quantity</b>: 5532.0 LKF Punkte</p></blockquote></div>"
},
"extension" : [
{
"url" : "https://elga.moped.at/StructureDefinition/moped-ext-diagnoseKnoten",
"valueCoding" : {
"system" : "https://elga.moped.at/CodeSystem/LKFAbrechnungsKnotenCS",
"code" : "D"
}
},
{
"url" : "https://elga.moped.at/StructureDefinition/moped-ext-fondsrelevanz",
"valueCoding" : {
"system" : "https://elga.moped.at/CodeSystem/FondsrelevanzCS",
"code" : "J"
}
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "institutional",
"display" : "Institutional"
}
]
},
"use" : "claim",
"patient" : {
🔗 "reference" : "Patient/Patient42"
},
"created" : "2025-08-30",
"insurer" : {
🔗 "reference" : "Organization/SV11"
},
"provider" : {
🔗 "reference" : "Organization/KHK999"
},
"encounter" : [
{
🔗 "reference" : "Encounter/Encounter42"
},
{
🔗 "reference" : "Encounter/TransferEncounter42.1"
},
{
🔗 "reference" : "Encounter/TransferEncounter42.2"
}
],
"diagnosisRelatedGroup" : {
"coding" : [
{
"system" : "https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS",
"code" : "HDG01.12"
}
]
},
"supportingInfo" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
"code" : "PLAUS"
}
]
},
"valueString" : "2"
},
{
"sequence" : 2,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
"code" : "ENDG"
}
]
},
"valueBoolean" : true
}
],
"diagnosis" : [
{
"sequence" : 1,
"diagnosisReference" : {
🔗 "reference" : "Condition/Condition42.1"
},
"onAdmission" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosis-on-admission",
"code" : "unknown"
}
]
}
}
],
"item" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "LDFPLK"
}
]
},
"quantity" : {
"value" : 366.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 2,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "LDFPTK"
}
]
},
"quantity" : {
"value" : 2730.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 3,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "SCULK"
}
]
},
"quantity" : {
"value" : 0.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 4,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "SCUTK"
}
]
},
"quantity" : {
"value" : 0.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 5,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "BDZU"
}
]
},
"quantity" : {
"value" : 0.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 6,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "INTZU"
}
]
},
"quantity" : {
"value" : 2436.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 7,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "MELZU"
}
]
},
"quantity" : {
"value" : 0.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 8,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "SCSPEZ"
}
]
},
"quantity" : {
"value" : 0.0,
"unit" : "LKF Punkte"
}
},
{
"sequence" : 9,
"category" : {
"coding" : [
{
"system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
"code" : "SCGES"
}
]
},
"quantity" : {
"value" : 5532.0,
"unit" : "LKF Punkte"
}
}
]
}